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Back pain usually improves within a few weeks with simple steps at home
Back pain is very common, and it usually improves within a few weeks [1]. Staying active is the first thing to try, and a few warning signs mean you should not wait [1][2].
Key points
- Most back pain gets better on its own within a few weeks, though it can last longer or come back [1][3].
- Keep moving and avoid long periods in bed. Heat can help [1][2].
- Opioids, benzodiazepines, gabapentin, pregabalin and acetaminophen are not routinely recommended for sudden low back pain [2].
- Numbness in both legs, loss of feeling around the genitals or anus, bladder or bowel changes, or pain after a serious accident need emergency care [1].
- Pain that has not improved after a few weeks deserves a visit to your primary care doctor [1][3].
Staying active is first-line care for back pain at home
Keep going with your daily activities as much as you can. For pain with no specific cause, first-line care is staying active, using heat, and trying other treatments that do not involve medicine [2].
- Keep up your normal routine as best you can, and do not stay in bed for long periods [1].
- Use a heat pack wrapped in a cloth to relieve stiffness or muscle spasms [1].
- Use an ice pack wrapped in a cloth if you want to reduce pain and swelling [1].
- Try gentle exercises and stretches for back pain. Stop if your pain gets worse [1].
- Try walking, swimming, yoga or pilates, which may also help ease back pain [1].
Most people find that reclining or lying down eases low back pain, whatever the cause [3]. Resting briefly is fine. Staying in bed for long stretches is what to avoid [1].
Why movement matters
Exercise showed some evidence of improving pain and daily function in the first weeks after pain starts. The trials were not strong enough for firm conclusions [4].
Common back pain medicines have limited or mixed support
Medicine is not the main tool for sudden low back pain, and several common choices have weak evidence behind them [4][5][2]. Check with a pharmacist or doctor if you are unsure which painkiller suits you [1].
| Type | What the evidence says |
|---|---|
| NSAIDs (anti-inflammatory painkillers) | Guidelines list them as a first medicine choice, and a Cochrane review found them slightly better than placebo [6][2]. |
| Acetaminophen | Not recommended on its own for back pain [1]. Not routinely advised [2]. |
| Muscle relaxants | Three commonly used ones did not show proven benefit in acute low back pain [5]. |
| Opioids | Cannot be recommended for sudden low back pain [4]. Not routinely advised [2]. |
| Benzodiazepines, gabapentin, pregabalin | Drugs that should not routinely be used [2]. |
The research on anti-inflammatory painkillers has limits. One recent team could not complete its planned analysis because the older trial data were hard to obtain [6].
When to get care
Certain back pain signs need emergency care or prompt medical attention
Very rarely, back pain signals a serious problem such as a broken bone, cancer or an infection [1]. These signs need emergency care [1]:
- Pain, tingling, weakness or numbness in both legs [1].
- Loss of feeling around the genitals or anus [1].
- Changes in bladder or bowel control, such as difficulty urinating or losing control of urine or stool [1].
- Changes in sexual function, such as trouble getting or keeping an erection or reaching orgasm [1].
- Pain that started after a serious accident, such as a car crash [1].
If you need emergency care, ask someone to drive you rather than driving yourself [1].
These signs need prompt medical attention [1]:
- Feeling hot, cold, shivery or generally unwell along with back pain [1].
- Severe pain that starts suddenly or is getting worse quickly [1].
Fever, chills or unexpected weight loss with back pain are also reasons to call your doctor [3].
If you think you may have a medical emergency in the United States, call 911 or go to the nearest emergency room.
Your primary care doctor can assess back pain that lingers or looks unusual
Pain that does not get better within a few weeks should be checked, whatever your age or symptoms [3]. Other reasons to book a visit include these:
- It is stopping you from doing your day-to-day activities [1].
- You are worried about the pain or struggling to cope [1].
- There is a lump or swelling in your back, or your back has changed shape [1].
- It does not improve with rest or is worse at night [1].
- It is worse when you sneeze, cough or strain on the toilet [1].
- It comes from the upper back between the shoulders, not the lower back [1].
- You have a history of cancer, vascular or arterial disease, or pain that is always present whatever you do [3].
Many people with low back pain do not need imaging. Aside from a recent injury, scans are usually reserved for warning signs [2]. If pain lasts beyond 8 weeks despite appropriate treatment, imaging and lab tests may be considered to look for a specific cause [2].
A back exam checks movement and leg nerve function
Your doctor will ask about your symptoms and history, then examine your back [3]. They may press on different areas to see if it hurts and have you bend forward, backward and side to side [3]. They may also check reflexes, strength and sensation in your legs to measure nerve function [3].
Pain that runs from the buttock down the leg, sometimes with numbness, tingling or weakness, can come from a herniated disk pressing on a nerve [3]. A herniated disk is when the soft center of a spinal cushion pushes outward [3].
Longer-lasting back pain has further treatment options
Back pain can last longer or keep coming back [1]. If it does not improve after a few weeks, other treatments may be recommended [1].
- Manual therapy, where a trained therapist massages and moves the muscles, bones and joints in your back [1].
- A procedure that seals off some nerves so they stop sending pain signals, used only for long-term lower back pain [1].
- Surgery, which may be an option if a condition such as a slipped disk is the cause and other treatments have not helped [1].
Doctors may also look at other health conditions that raise the chance of sudden back pain becoming long-lasting [2].
Sources
- Back pain nhs.uk
- Acute Low Back Pain: Diagnosis and Management American family physician
- Low Back Pain orthoinfo.org
- Efficacy of exercise and opioid interventions in improving pain and functioning outcomes in acute low back pain: a systemic review The British journal of general practice : the journal of the Royal College of General Practitioners
- [Systematic review of the literature and evaluation of the effectiveness of muscle relaxants in acute low back pain according to REB method] Therapie
- Challenges in conducting an individual participant data meta-analysis of non-steroidal anti-inflammatory drugs for patients with (sub)acute low back pain: a systematic review and report on data availability BMJ open
Not medical advice. This page is general education written from the sources above. It cannot diagnose a condition or replace a licensed clinician who knows your history. If you may be having an emergency, call your local emergency number or go to the nearest emergency department.